Sciaticais a common presentation of patients with back pain in Singapore. Though according to health hub about 80% of adult population may suffer from Back pain in Singapore, with varying degree at some time in their life, 10% may present with Sciatica or pain that travels down the leg.
Sciatica Nerve is a spinal nerve that follows a long path from the lower two levels of spine L4-5 and L5-S1, through the buttock, down the back of the thigh and leg, and finally ends in the foot. Pain may increase with sneezing, coughing, lifting or sitting.
It’s a cramp-like pain that can be sharp or burning pain anywhere from the lower back and hip, and going down the back of one leg or foot.
There may be:
Pins and needles
Numbness and Tingling
Weakness of the leg and foot
Sciatica can be due to a Spinal disc compression or slip discor from Muscles of the buttock pressing the nerve like in piriformis syndrome and also Spinal stenosis.
Physio Asia Singapore has been successfully treating patients with Sciatica with specialized Physiotherapy including:
Low back pain https://physioasia.com/back-pain/is one of the most common afflictions in our society. Back pain ranges from mild pain (with activities) to extreme pain (that cannot seem to find a comfortable position to be in), from a sharp catching pain to dull ringing ache, from centralized pain at the lower back to radiating pain and even numbness, pins and needles down the legs.
It is important to be able to differentiate between these presentations and manage the pain accordingly. The following sequence of therapy helps with long term pain
Mobilisation or manual therapy: Significant effect to restore restricted mobility between the spinal vertebrae. This aids to reduce pain, muscle spasm and stiffness.
This Technique utilizes slow sustained Decompression (Pull) force on the Disc – for disc herniation – to facilitate the healing of the ruptured or prolapsed disc.
Many patients may feel better after initial back pain with traditional treatment but their symptoms can return within a few days. As a side effect of the recurrent back pain, core muscles become weak and do not get activated as efficiently resulting in loss of appropriate back curvature and thereby causing increased stress on the spine.
SCORES use a combination of Real-time Ultrasound to see the core muscles in action, and with Achievo Stabiliser one learns the correct activation of these muscles thereby preventing Back pain.
A sharp pain or discomfort in the heel on weight bearing especially after a rest period is a common complaint. It settles down quickly if treated early and given enough rest, but may become worse and chronic if initial symptoms are ignored.
COMMON CAUSES OF HEEL PAIN: Heel pain can be either due to plantar fasciitis or heel spur syndrome.
PLANTAR FASCIITIS As a person gets older, the fascia becomes less elastic. The heel pad becomes thinner and loses the capacity to absorb as much shock.
There may be some swelling, small tears or bruises in the plantar fascia with the pounding force on the heel.
RISK FACTORS
Being overweight
Diabetes
Prolonged standing or walking
Increasing activity over a very short period of time
Injury
Being flat-footed or having a high arch
Wrong or improperly fitting footwear
Wearing high heels for long
The younger people who are more active in sports, may suffer from heel pain too.
HEEL SPURS A heel spur is a bony growth that develops on the underside of the heel bone, where the fascia is attached. This is a result of excessive and repetitive pulling of the plantar fascia on the heel bone. The heel spur may press into the sensitive nerves and soft tissues, causing pain in the foot. Heel spurs can be seen as hook shaped protrusions in X-rays.
HEELS SPURS ARE COMMONLY SEEN IN:
Middle-aged patients
Athletes are especially prone to heel spur due to the repetitive stress on their heels
Abnormal walking pattern or pronation with fallen or flat arches
SYMPTOMS
Burning, stabbing, or aching pain in the heel or along the arch of the foot
Most people would feel it first thing in the morning because the fascia ligament tightens up during the night sleep.
In most cases, plantar fasciitis/ heel spur does not require surgery or invasive procedures to stop pain and reverse damage. Conservative treatments are usually all that is required.
At Physio Asia Therapy Centre we will assess the cause and type of your heel pain and treat it accordingly. Treatment involves pain relief and lower limb strengthening program. Radial Shockwave Therapy: A new non-invasive treatment to help with a healing response by the body by causing blood vessel formation and increased delivery of nutrients to the affected area.
Cold Laser: Works on deep tissue to reduce local pain and helps with wound healing.
Ultrasound:improves circulation of the inflamed area, thus enhancing tissue healing.
Mobilization & Manual Therapy: Our physiotherapist will mobilise your foot to reduce restricted mobility between the foot bones or muscle. This helps to reduce pain and stiffness.
Foot Taping:Taping supports the foot, placing stressed muscles and ligaments in a restful state.
Stretches/Strengthening Exercises: Stretching the tight muscles/fascia as well as some leg/ankle strengthening exercises can help to reduce the strain on the fascia.
Orthotics or Insoles: We customise insoles to help improve the weight bearing positions on the foot to recover normal patterns of movement.
OUR SUGGESTIONS:
Wear the proper shoes for each activity.
Do not wear shoes with excessive wear on heels or soles.
Prepare properly before exercising.
Pace yourself when you participate in athletic activities.
If overweight, lose weight.
Visit a physiotherapist and have it treated early. So Call Us Today.
Have you ever wanted to start the day with a relaxing morning walk to put yourself in the right frame of mind for the rest of the day? But you remember that your knee hurts during long walks, so you decide to snooze the alarm and sleep in until it’s time to go to work?
Knee pain is a common and debilitating condition which often leads to a sedentary lifestyle. This worsens the severity of the condition and traps people in a vicious cycle of inactivity and knee pain which they find difficult to break out of. However, knee pain should not stop you from living a fun and active life!
Here are 6 simple ways that you can combat knee pain and allow yourself to stay active and pain-free:
1. Stretch Regularly Flexibility – Use It or Lose it!
Many of us are guilty of sitting for 6-8 hours at school or work only to return home and sit in front of the television or computer for another hour or two. These stationary positions reduce the flexibility of the muscles in the body which result in increased tension at the knee joint and can lead to knee pain.
A simple solution which most of us know about but rarely do is to stretch! A regular routine of simple stretches (which can even be done at work or school) can make a significant change to some types of knee pain.
Some simple stretches are:
Hamstring Stretch 1. Sit at the edge of your chair 2. Straighten leg with toe pointing to ceiling 3. Keep your back straight and relaxed 4. Bend forward from your hips 5. Feel a gentle stretch at the back of your thigh.
Quadriceps Stretch 1. Stand behind a chair 2. Hold onto chair for support 3. Bend leg and hold onto ankle 4. Keep your back straight and relaxed 5. Pull your thigh backwards 6. Feel the stretch at the front of your thigh 7. Hold for 15 seconds
Calf Stretch 1. Sit at the edge of your chair 2. Wrap a belt/towel around the ball of your foot 3. Straighten your leg 4. Pull your foot towards you with the belt/towel 5. Feel a stretch at the back of your calf 6. Hold for 15 seconds
These stretches can be done regularly throughout the day.
2. Good Posture Sitting with your back rounded may feel comfortable but it puts your hips in a rotated position which in turn places the muscles at the back of the thigh in a shortened position. As mentioned above, this puts more stress on the knee joint, which may contribute to the pain felt at the knee.
Some simple tips to ensure good sitting posture are to: 1. Sit back into the chair 2. Ensure lower and middle of the back are in contact with the backrest
3. Do not cross legs 4. Ensure feet are in contact with the groun
3. Change Positions Regularly
Sit, Stand, Sit, Repeat!
Ever gotten so engrossed in your work that you stayed seated at your desk for hours on end? So have I! But ‘Motion is Lotion’ and ‘Rest is Rust’. Staying in one position for a prolonged duration, even with a good posture, results in the stiffening of muscles and joints.
Taking short breaks every half an hour by walking around or even standing up for a minute can make a difference to the body’s flexibility.
A well-fitted pair of running shoes with the appropriate arch support for your feet ensures that the forces generated when walking or running are transmitted correctly through the ankles, knees and hips without causing unnecessary stress at the joints. Additionally, ensure that the soles of your shoes are not worn out and if they are, it’s time to get a new pair!
5. Stay Active with Aqua Exercises! I Like To Move It, Move It!
Knee pain often makes walking an impractical form of exercise due to the pain experienced during weight bearing.
One solution is to try walking in a swimming pool! The buoyancy of the water reduces the weight of the body and decreases the stress placed on the knees. This serves as a good form of low-impact cardiovascular exercise. At the same time, the resistance generated by walking in water strengthens the leg muscles!
Try walking forwards, backwards and side-ways to strengthen different groups of muscles.
6. Moderation is Key
With all things in life, moderation is the key to maintaining consistency. Although we encourage developing a routine of regular stretching and exercising, it is important to start at a low intensity and frequency and gradually progress at your own pace. This reduces the chances of worsening your pre-existing symptoms, which may reduce your motivation to stay active!
*Please ensure that there is no pain when performing any of the exercises listed above. Consult a Physiotherapistbefore trying any of the exercises if you are unsure of how to do them or if you need assistance in developing an exercise plan.
Patellar tendinopathy (jumper’s knee) is a condition characterized by pain felt at the inferior pole of patella (kneecap). It is a condition which affects individuals who participate in sports; which require repetitive loading of the patellar tendon. The diagnosis is made clinically; thus, please consult a Doctor and then a Physiotherapist if you experience any symptoms around the knee joint.
Patients at our clinic leave with reduce pain after treatment with modalities (electrical stimulation, ultrasound and Cold Laser). With activity modification, biomechanical correction, the right stretching and strengthening exercises, they also resume to higher functioning activities pain free. Our 3D Gait analysis also helps to objectively identify errors in walking and running activities and monitor improvements throughout the sessions.
Sometimes pain from other areas of the body, such as the groin pain (e.g. hernia) or back pain (e.g. Sciatica), can radiate to the hip. There can be many causes of hip pain, you may have discomfort in your:
Groin
Thigh
Buttocks
Inside of hip joint
Outside of hip joint
If you have hip pain, physiotherapy may be able to help your pain and improve your mobility. Read about the types of hip conditions you may need physiotherapy for.
Osteoarthritis of hip is degeneration or wear and tear between joint surfaces of the hip. It usually occurs in hips that have experienced trauma, infection or injury or age related changes. Osteoarthritis develops as the cartilage that protects the bone ends thins down and the bones will begin to rub against each other when the joint is moved resulting in narrowing of the joint space between the bones. The surrounding bones react by becoming thicker and grow outward and form bone spurs. All these changes can lead to pain, swelling and discomfort in the hip on movement or rest.
Rheumatoid Arthritis: is caused by an overactive immune system. The hip joint, like other joints in the body, is protected by a capsule that completely surrounds the joint. This capsule has an inner synovial lining that is filled with lubricating joint fluid that helps with smooth joint movement. Rheumatoid arthritis produces inflammation of the synovial lining and eventually causes erosion of the cartilage and underlying bone, resulting in damaged and deformed joints. Symptoms include fatigue, stiffness, swelling, and pain in the hip.
Ankylosing Spondylitis: is a genetic condition leading to inflammatory arthritis of the hip. Early signs and symptoms of ankylosing spondylitis might include dull achy pain along with Stiffness in the lower back and hips, especially in the morning and after periods of inactivity. Fatigue is also common. Symptoms might worsen with time, improve or stop at irregular intervals.
Snapping Hip syndrome: is a condition in which you feel a snapping sensation or hear a popping sound in your hip when you walk, get up from a chair, or swing your leg around. This occurs when a muscle or tendon moves over a bony protrusion in your hip. This condition can be painless and harmless even though the sensation can be annoying. However, in long standing cases, snapping hip can lead to hip bursitis that is a painful swelling of the fluid-filled sacs lying over the hip joint.
Trochanteric Bursitis: Inflammation of bursa (sac of fluid) on the outer side of the hip can be a common source of pain on outer hip or thigh. The pain usually worsens with physical activity, example – when a person walks up the stairs. The pain is usually worse at night, especially when a person is lying down or has been lying on their side for some time. If the tendons around the hip bone are also inflamed, symptoms may be worse.
Labral injuries: Labrum is a ring of cartilage present on the outside rim of the socket of your hip joint. It helps to cushion the hip joint and hold it into place. Hip Labral Tears can occur either due to a structural deformity which can lead to degeneration or trauma such as injury or dislocation to the hip joint. Patients usually complain of pain in front of the hip joint along with stiffness of the hip joint. This may present with locking, clicking or catching sensation in the hip joint Patients may experience difficulty climbing stairs, prolonged walking and prolonged standing. A hip labral tear may predispose you to develop osteoarthritis of hip joint in the future.
Hip replacement surgery: Total hip replacement –THR to reduce pain and improve function in chronic conditions such as Hip Osteoarthritis, rheumatoid arthritis, osteonecrosis. For a full recovery following hip replacement surgery, regular exercises are important to restore normal hip movements and strength and a gradual return to daily activities. These exercises are important for increasing circulation to your legs and feet to prevent blood clots and reduce any post-op swelling.
Hip Impingement Syndrome: is due to increased friction during hip movements that may damage the joint. Patients usually complain of pain in the groin after prolonged sitting or walking. Occasionally, a popping or clicking in the front of the hip is felt by the patient. Pain may also radiate along the side of the thigh and in the buttocks.
Tendinitis: Inflammation of tendons surrounding the joint.
At Physio Asia we don’t just to help you get rid of the present pain by just managing your symptoms but also find long term solutions to help you stay fit and pain free.
In simple terms, orthotics are special shoe inserts that are custom made to support the natural shape of the foot, align the hip, knee and ankle in order to improve the posture.
Foot acts as the base on which the whole body rests. It is very important to have the foot in an anatomically and biomechanically right position, which is called the neutral position of the foot.
The parts of the foot, which consists of the fore foot, mid foot and the hind foot, should be aligned well so as to counter the ground reaction forces, frictional forces and the body weight.
It is estimated that up to 85% of the population suffers from excessive pronation and related conditions. Dysfunction of the lower limb should be attributed to two factors:
Slight bowing of leg when approaching the ground during the gait cycle
Biomechanical deformity factors
When these two factors combine, excessive pronation often results which contributes to:
mal-tracking & misalignment of the knee and hip joints
over compensation of the lower back muscles
Joints on heel and rear footare more mobile and require more muscle work to maintain stability compared to a supinated foot position
Supination or under pronation of the foot occurs when the body weight falls on the outer edges of the feet. In a normal gait cycle, the foot should roll inward (pronate) so as to facilitate the toe off.
Excessive supination and excessive pronation lead to problems with the body’s alignment resulting in pain in the feet, knees, hips and back.
Function of Orthotics Re-aligning the lower limbs to the neutral calcaneum stance position (neutral position of the foot) using the orthotics along with the treatment program assist in correcting foot function and can provide relief from painful biomechanical complaints like Bunions, Plantar fasciitis, Heel spurs, knee pain, osteo-arthritis, lower back pain.
How is it done?
Measurements are taken by the Physiotherapist at Physio Asia.
Examination of the foot is done in and off weight bearing position.
Fore foot, mid foot and hind foot alignments are taken into consideration in relation to hips and pelvis.
Shoe insolesare customized in the same session, heat-moulded according to the foot position to get the best fit.
Insoles can be done for sports or work shoes as well as heels for ladies.
These can be moved between similar pair of shoes too.
Patients are called for review after 2 weeks and 4 weeks of using the orthotics.
Is running becoming difficult? Not able to find answers to the pain in your hips, knees, shins or feet? Is the pain not getting better despite going through rehabilitation, change of footwear, using orthotics and other interventions?
The solution to the problems above is ‘RIGHT DIAGNOSIS’.
Right diagnosis helps in zeroing in on the root cause and problem areas so that the appropriate and correct treatment can be administered according to your needs.
At our clinic, apart from doing regular assessments, our 3D Gait system provides a comprehensive data analysis of your posture and movements in standing, walking and running. It is an innovative system that assesses how the pelvis, hips, knees and ankles rest and move in the different functional activities. It allows us to accurately and objectively detect normal and abnormal movement patterns, which can cause or lead to an injury, treat the issue and conduct a reassessment and record your recovery progression.
Having the right diagnosis the first and most important step in your recovery process.
Book an appointment with us to find out more and experience this for yourself!
(+65)67364142 
